Big pharma has taken a new course over the past few years. In the past, most useful drugs originated in some kind of living organism – penicillin, quinine, insulin, etc etc. Nowadays, big pharmaceutical companies use combinatorial chemistry and computer modeling. Merck has sold off its biological-products research arm. This new approach, combined with doubled spending on drug R&D, has been a resounding failure. The rate of development of fundamentally new drugs – ‘new molecular entities’ - is running about 40% of that seen in the 1970s. Since big pharma makes its money from drugs that are still on patent, this slowed innovation is a real threat to their bottom line.

Yes, but pharmaceutical companies do still seem to manage to come up with the brilliant innovation of a new version of their pills with a "slow release" coating just before the old version goes off patent. Thank God they figure out the complexities of the SR version just in the nick of time.

You get more complicated molecules from biological products, molecules that have been optimized by billions of years of evolution. Sometimes they do what you want or need. ...

I think that this is an instance of a more general trend: often a modern, advanced approach shows up, and it persists long after it’s been shown to be a miserable failure. You can see some of the reasons why: the people trained in the new technique would lose out if it were abandoned. Hard to imagine combinatorial chemists rooting around in a garbage can looking for moldy fruit.

There's a related general trend that many things take longer to get working right. For example, the F-22 fighter plane goes back to a 1981 Air Force request for proposals, but the Air Force is still trying to figure out how to keep the F-22 from asphyxiating its pilots.